This invention relates generally to a data processing system and method for evaluating medical treatment. More particularly it relates to a data processing system and method for evaluating treatment of chest pain patients.
Coronary heart disease is the number one killer of Americans. It accounts for nearly twenty percent of the national health care budget. The chief complaint of between five and eight percent of the patients seen in emergency departments in 1994 was chest pain. However, only a small percentage of patients experiencing chest pain have acute myocardial infarction (AMI) or a significant risk of AMI.
Traditionally, most patients who complained of chest pain were admitted to hospitals for evaluation until a determination could be made concerning whether the patient had AMI or was at significant risk of AMI. Inpatient evaluation of chest pain is very expensive. In response to the high cost of inpatient evaluation many hospitals have developed alternatives to inpatient evaluation.
The Emergency Chest Pain Unit was originally designed as a way to prevent primary ventricular fibrillation. It usually falls within the province of the Emergency Department. Today it is charged with responsibility for early recognition and treatment of patients with AMI. Another alternative is the Observation Unit. It is distinct from the Emergency Chest Pain Unit. The primary function of the Observation Unit is the early diagnosis and risk stratification of patients with underlying occult coronary artery disease. The use of alternatives such as these reduces the cost of treating chest pain, while allowing the proper diagnosis and treatment to occur. Hospitals need a way to evaluate the performance of these alternatives to inpatient care and to compare the performance of inpatient treatment with emergency department treatment and treatment in an observation unit.
Rapid identification and treatment of patients with AMI is critical to their survival. Early intervention dramatically improves outcomes no matter what reperfusion strategy is used.
The standardization of the evaluation and treatment of patients complaining of chest pain is an important part of improving care. The National Heart Attack Alert Program Committee, the American Heart Association, and the American College of Cardiology have made specific recommendations that result in improved outcomes. For example, a goal of thirty minutes from entry into the emergency department to treatment with thrombolytic therapy has been established by the National Heart Attack Alert Program Committee. In order to evaluate the effectiveness of these recommendations, it is important to be able to document and measure the performance of the recommendation accurately. Currently, there is no way to measure this performance objectively.
Since rapid diagnosis and treatment of AMI are critical to patient survival, hospitals must be able to evaluate the performance of medical care providers objectively. Adherence to treatment protocols is an important factor in this evaluation. However there is no objective way to measure adherence currently.
In addition, failure to diagnose heart attack is the number one malpractice problem in Emergency Medicine today, accounting for almost twenty percent of all malpractice dollars paid out. Emergency chest pain evaluation is a high volume, high risk arena. An organized system-wide approach to the diagnosis of heart attack can be viewed as a risk management tool.
Therefore, it would be desirable to have a way to evaluate objectively the performance of treatment protocols and the adherence of medical care providers to the treatment protocols in the treatment of chest pain.